Sleeve Gastrectomy

The laparoscopic sleeve gastrectomy (LSG) is also known as the vertical sleeve gastrectomy (VSG) and gastric sleeve. This surgery is a permanent irreversible operation performed via keyhole surgery where a large portion of the stomach is removed.

Normally the stomach is an expansible muscular bag (imagine it like a balloon that expands and deflates) which can have the capacity of 1.5L-2L. Following the sleeve gastrectomy procedure the capacity of the stomach is reduced to approximately 150mL-200mL.

To perform this surgery, I divide the stomach with surgical staples along its entire length and the larger portion of stomach which has been divided is removed. The remaining stomach is long and narrow and roughly the shape of a banana and is approximately 1/10 the size of the original stomach. This narrower stomach is often referred to as a pouch or sleeve because of its shape and smaller size.

Following the laparoscopic sleeve gastrectomy weight loss occurs due to two key reasons:

Metabolic effects

The stomach produces a number of different hormones (e.g. ghrelin) which signal the brain as well as the digestive tract. After surgery these hormonal levels change and thus the messages to the brain and the body alter. These changes result in a significant decrease in appetite, promote the feeling of fullness and change glucose metabolism, amongst many other metabolic effects.

Restrictive effects

The newly sleeved stomach is significantly smaller and is easily filled

The sleeve gastrectomy is the most commonly performed weight loss operation in Australia and world-wide. Its origins are based on the biliopancreatic diversion with duodenal switch operation – a more restrictive and malabsorptive operation pioneered in the 1980s.

The gastric part of that operation become a stand-alone operation in the late 1990s. Since then the sleeve gastrectomy techniques has markedly evolved. The sleeve gastrectomy from 10 years ago is different to what is being performed today. Indeed there are subtle, but important differences in technique between countries, and even between states and individual practices.

At our practice we recognise that your success is not just about the most up-to-date surgical technique. Our team approach includes dietitian and psychological support to help you achieve your goals. Please contact us if you would like to make an appointment to discuss your weight loss surgical options with me.

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